Tuesday, July 3, 2012

Emry's Episode

Today my youngest daughter Emrys (5.5 months old) had an odd episode. Basically, after her bath I laid her on a towel, and turned my head to grab a nearby towel. I looked away for maybe ten seconds max. When I looked back at her she had turned blue. Her lips, gums, and tongue were so deeply colored they resembled a glass of merlot, or a ripe plum. Her hands, feet and face were light blue. It was terrifying.

I first thought she might be cold, so for about 15-20 seconds I just stared at her. She was clearly scared, almost panicky. I decided she was more than cold, and lifted her up. As soon as I did she gave me some chunky breastmilk puke. (Sorry for the fun adjectives). This is quite normal for her. I thought this might have been her issue, but she was still blue and seemed uncomfortable. I thought to myself, If she can nurse then she's probably OK. I figured nursing meant that she could breath and swallow fine. So I latched her on, and she did nurse fine for about 30 seconds. I figured she was OK after that and just held onto her. After about 10 minutes her lips, gums, tongue and hands and feet were all back to normal.

I was still scared, but not panicked. I figured I'd just write this off as scary and move on with my day. But all my facebook friends seemed to think I should call the doc and have Em checked out. Turns out the Doc agreed that she should be seen ASAP (Which in doctor hours means in 4 hours.)

4 hours later we went to the docs office. Emrys had still been acting fine. She had nursed and even napped. I was sure she was OK, but still better safe than sorry. They checked Em's blood-oxygen saturation level, her pulse, her heart and her lungs. They checked the windpipe for obstructions and had me tell the story to two nurses and the doctor, three times through just to make sure I didn't leave any details out.

At the end, the doctor told me what he suspected happened was a perfect storm of conditions that would probably never replicate. Basically, she had been just on the verge of spitting up when I moved her from the tub to the towel, and said vomit had a touch more acid in it than her system is accustomed to (blame it on my dinner or breakfast.) When that fore-acid hit her windpipe, the windpipe reacted exactly the way it is supposed to react, and the way in which it would react if you or I had acid hit it un-expectantly. It closed tight.

In you, I or even an older child (as young as 12 months) the body would recognize what it had done and instantly relax, thus keeping the acid splash out of our lungs but reopening the windpipe before we even feel short of breath. If we did notice at all, it'd feel like a gasp or having the wind knocked out of you. But in infants who have never experienced this, the initial and biological reaction is panic. The more Emrys panicked, the tighter her windpipe constricted. This is why she went so blue so fast. When I lifted her and the vomit was expelled, it cleared the windpipe. When I latched her on to nurse, the doctors suspect this is when she felt calmed and relaxed, allowing the windpipe to reopen.

The doc applauded my actions (honestly, he made me blush. It was almost uncomfortable.) He said that most times when this happens, the parents flip out and either call 911, drive the kid to the hospital on their own, or become so panicky themselves that it's impossible for the infant to calm down. He said in these cases, the vomit that had been about to come up could easily have been aspirated, creating a real problem. But my staying calm and observing her thoroughly before acting (even though that phase only lasted about 20 seconds) allowed me to get enough information for them to accurately diagnose the situation, and it allowed me to create a calm environment for Emrys.

While my self diagnosis in the moment of nursing being my indicator wasn't quite on the money, the doc said I was probably right that this action was what calmed her enough to reopen the windpipe. Though really, just holding her could have had the same effect- who knows?

The story ends with knowing that it is unlikely this will ever happen again, she had to have just enough acid in the vomit, and be ready to vomit at the exact moment I moved her and then be too panicked to release the windpipe on her own.

My baby is healthy, happy and breathing fine. Thank you all for your concern and prayers over her today.